Cup Positioning in Primary Total Hip Arthroplasty Using an Imageless Navigation Device: Is There a Learning Curve?

Thorey, Fritz; Klages, Phillip; Lerch, Matthias; Flörkemeier, Thilo; G, von Lewinski

doi:10.3928/01477447-20090915-52

Cited by 27 publications

(19 citation statements)

References 17 publications

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“…Thorey et al [25] reported that navigation may lead to a reduction in the length of the learning curve, improve the surgeon's ability, and minimize outliers for inexperienced surgeons. However, whether navigation is useful in achieving precise placement of the cup regardless of the level of surgical experience remains unclear.…”

Section: Discussionmentioning

confidence: 99%

Accuracy of angle and position of the cup using computed tomography-based navigation systems in total hip arthroplasty

Iwana

Nakamura

Miki

et al. 2013

Computer Aided Surgery

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Objective: The objectives of this study were to evaluate the accuracy of computed tomography (CT)-based navigation and to investigate whether the level of surgeon experience affects the accuracy of cup positioning under navigation. Methods: This study investigated 117 hips in 103 patients who underwent primary total hip arthroplasty (THA) by 7 surgeons using a CT-based navigation system. Pre-and postoperative CT images were matched using a volume registration technique. Postoperative cup angles and positions were then measured using the same pelvic coordinates, and results were compared for experienced and inexperienced surgeons. Results: The mean absolute error of the cup angle was 1.8 AE 1.6 for inclination and 1.2 AE 1.1 for anteversion. The mean absolute errors of cup position were 1.9 AE 1.5 mm, 1.4 AE 1.2 mm, and 1.9 AE 1.3 mm on the x-, y-and z-axes, respectively. No significant differences in accuracy were identified between experienced and inexperienced surgeons. Conclusions:The absolute spatial error of cup position was 2 mm for each axis, and the angle error was 2 for the angles of inclination and anteversion. This navigation system could therefore help surgeons perform accurate cup placement irrespective of the surgeon's level of experience.

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Section: Discussionmentioning

confidence: 99%

Accuracy of angle and position of the cup using computed tomography-based navigation systems in total hip arthroplasty

Iwana

Nakamura

Miki

et al. 2013

Computer Aided Surgery

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“…The costs associated with these devices can be prohibitive for some facilities, with capital costs reaching $250,000 and software/maintenance accounting for tens of thousands of dollars of additional costs per year [ 36 , 37 ]. Additionally, the learning curve associated with their use can require extended periods of time (up to 50 cases) before surgeons achieve proficiency [ 38 ]. Finally, while providing accurate measurements, these devices have been associated with significant increases in procedural time, ranging from 12 to 23 minutes per procedure [ 11 , 17 ].…”

Section: Discussionmentioning

confidence: 99%

Minimal Increase in Total Hip Arthroplasty Surgical Procedural Time with the Use of a Novel Surgical Navigation Tool

Christ¹,

Ponzio²,

Pitta³

et al. 2018

TOORTHJ

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Background:Computer-assisted navigation has proven effective at improving the accuracy of component placement during Total Hip Arthroplasty (THA); however, the material costs, line-of-site issues and potential for significant time increases have limited their widespread use.Objective:The purpose of this study was to investigate the impact of an imageless navigation device on surgical time, when compared with standard mechanical guides.Methods:We retrospectively reviewed prospectively collected data from 61 consecutive primary unilateral THA cases (posterior approach) performed by a single surgeon. Procedural time (incision to closure) for THA performed with (intervention) or without (control) a computer-assisted navigation system was compared. In the intervention group, the additional time associated with the use of the device was recorded. Mean times were compared using independent samples t-tests with statistical significance set a priori at p<0.05.Results:There was no statistically significant difference between procedural time in the intervention and control groups (102.3±28.3 mins vs. 99.1±14.7 mins, p=0.60). The installation and use of the navigation device accounted for an average of 2.9 mins (SD: 1.6) per procedure, of which device-related setup performed prior to skin incision accounted for 1.1 mins (SD: 1.1) and intra-operative tasks accounted for 1.6 mins (SD: 1.2).Conclusion:In this series of 61 consecutive THAs performed by a single surgeon, the set-up and hands-on utilization of a novel surgical navigation tool required an additional 2.9 minutes per case. We suggest that the intraoperative benefits of this novel computer-assisted navigation platform outweigh the minimal operative time spent using this technology.

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“…Thorey et al found a prolongation of the operative time to be 4.8±3.8 min after the learning curve (Thorey et al 2009). Thorey et al found a prolongation of the operative time to be 4.8±3.8 min after the learning curve (Thorey et al 2009).…”

Section: Evidence Of Benefits Using Navigationmentioning

confidence: 99%

Computer and Template Assisted Orthopedic Surgery

Haaker¹,

Konermann²

2013

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rial is concerned, specifically the rights of translation, reprinting, reuse of illustrations, recitation, broadcasting, reproduction on microfilms or in any other physical way, and transmission or information storage and retrieval, electronic adaptation, computer software, or by similar or dissimilar methodology now known or hereafter developed. Exempted from this legal reservation are brief excerpts in connection with reviews or scholarly analysis or material supplied specifically for the purpose of being entered and executed on a computer system, for exclusive use by the purchaser of the work.

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Cup Positioning in Primary Total Hip Arthroplasty Using an Imageless Navigation Device: Is There a Learning Curve?

Cited by 27 publications

References 17 publications

Accuracy of angle and position of the cup using computed tomography-based navigation systems in total hip arthroplasty

Accuracy of angle and position of the cup using computed tomography-based navigation systems in total hip arthroplasty

Minimal Increase in Total Hip Arthroplasty Surgical Procedural Time with the Use of a Novel Surgical Navigation Tool

Computer and Template Assisted Orthopedic Surgery

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